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Abstract

Background and Objectives: For patient comfort and security, transradial coronary angiography is more frequently. This access is associated with lower major vascular access site complications. However, the small size of the radial artery is a major technical limitation. A sheathless guiding hydrophylic coating catheter has recently been introduced that has a 1 to 2 French smaller diameter compared with the corresponding introducer sheath. The aim of this study is to investigate the feasibility and the security of using a 6.5 French sheathless guide catheter in patients who have small radial arteries.

Subjects and Methods: From March 2009 to February 2012, in 3 French hospitals, 148 consecutive patients were enrolled in this study who underwent transradial approach (TRA) for percutaneous coronary interventions (PCIs) using the 6.5 French sheathless “Eaucath” guiding catheter system because of small radial artery caliber.

Results: Among the 148 patients enrolled, 252 lesions were treated. There were more female patients in the study (64%). Procedural success using the 6.5 French sheathless guide catheter system was 100% with no cases requiring conversion to a conventional guide and catheter system. Multi-vessel interventions for the right and the left coronary arteries in the same procedure was performed in 13 patients (9%). During procedures, adjunctive devices used in this cohort included IVUS (2 patients), 36 bifurcated lesions were treated with a kissing balloon technique among 46 patients undergoing bifurcation PCIs, 1 patient had a saphenous vein bypass graft lesion requiring filter wire placement prior to intervention, 9 patients required rotational atherectomy, thrombus-aspiration catheters had used in 19 patients, FFR-guided angiography in 10 patients, alcohol septal ablation in 3 patients. We report 10 cases of chronic total occlusion successfully treated in 9 cases using this hydrophilic catheter. There were no radial artery site complications.

Conclusion: The use of sheathless guiding catheter system is a safe effective method for TRA-PCIs in case of complex lesions and small radial artery calibre.